Concepts of the Community: • It is the patterned series of interrelationships

existing between individuals, groups, &

institutions & forming a coherent whole.
Community – is a group of people who: • Its components that affect health include the
family, economic, educational,
• Have common interests or characteristics communication, political, legal, religious,
• Interact with one another recreational, & health systems.
• Have sense of unity or belonging • Types of Organizations:
• Function collectively within a defined social a. Formal – ex: government agency, bank,
structure to address common concerns. school
b. Informal – ex: neighborhood friends,
volunteers in a barangay clean-up drive.
A. Types of Communities
1. Phenomenological – functional E. Roles and Activities of CHN
2. Geopolitical – territorial 1. Advocate – seeks to promote an
understanding of health problems; looks for
B. Characteristics of a Healthy Family beneficial public policy & stimulates the
1. A shared sense of being a community based emergence of a supportive community action
on history & values. for health.
2. A general feeling of empowerment & control 2. Care Manager – clients need help in making
over matters that affect the community as a decisions about appropriate health care
whole. services. Achieving service delivery
3. The ability to cope with change, solve integration & coordination is a major task of
problems, & manage conflicts within the the CHN.
community through acceptable means. 3. Case Finder – the CHN looks for clients at
4. Open channels of communication & risk among the population served.
cooperation among the members of the 4. Counselor – clients in the community health
community. setting frequently face difficult & complex
5. Equitable & efficient use of community health concerns & desire supportive &
resources with the view towards sustaining problem-solving assistance. They deal with
natural resources. stress related to health concerns.
5. Clinic Nurse – clinic services are
C. Components/Features of a Community increasingly expanding to meet the needs of
1. People aggregates at risk.
2. Location 6. Epidemiologist – the CHN uses the
3. Social system epidemiological method to study disease &
health among various population groups & to
D. Factors Affecting Health of the Community deal with community- wide health problems.
1. Characteristics of the Population 7. Group Leader – the CHN works in groups in
a. Size & Density – negative effects of practice
overcrowding include: (1) easy spread of 8. Health Planner – the CHN provides health
communicable disease, (2) increased programs for the community.
stress among members of the 9. Home Visitor – the CHN enters the client’s
community, (3) rapid degradation of setting. He/She assesses the environment &
housing facilities, & water, air, & soil works within it. He/She also gathers
pollution. information about how a family system
- Sparsely populated areas have functions within its own setting. The CHN
limited resources resulting in difficulty also provides direct care services with
in providing health services. clients.
b. Differences in population composition by 10. Occupational Health Nurse – the CHN is
age, sex, occupation, level of education also concerned with risks & problems in the
& other variables. work environment of the people.
c. Rapid growth or decline – usually results 11. Researcher – the CHN assists health care
from migration of a large number of professionals in reaching their goals through
people into the community & from research.
disturbances brought about 12. School Nurse – the CHN works with
circumstances. students in school.
d. Cultural characteristics of the community. 13. Teacher – the CHN facilitates change in
e. Level of education & social class. behavior among clients which is a basic
2. Location of the Community intervention strategy in community health.
a. Natural variables – such as geographics
features, climate, flora, & fauna. CHN Activities:
b. Man-made variables such as community 1. Health education
boundaries, presence of open spaces, 2. Actively participate in the training component
quality of the soil, air & water, & the of the service like in Food Handler’s class &
location of health facilities is influenced attend training/workshops related to
by human decisions & behavior. environmental health.
3. Social Systems within the Community

1
 3. Assist in the deworming activities for the disease, which illustrate the changing structure
school children & targeted groups. of human populations.
4. Effectively & efficient coordinate programs/
projects/ activities with other government &
Sources of Data
non-government agencies.
5. Act as an advocate or facilitator to families in • Primary – is the original data collected for a
the community in matters of program/ specific purpose. Collecting primary data is
projects/ activities on environment health in expensive and time-consuming, and it usually is
coordination with other members of Rural undertaken only when secondary data is not
Health Unit (RHU) especially the Rural available.
Sanitary Inspectors. • Secondary – includes census, hospital data,
6. Actively participate in environmental vital registration system, health insurance,
sanitation campaigns & projects in the disease notification, school health program,
community. disease registries, downloadable data sets,
7. Be a role model for others in the community surveillance system & surveys (morbidity,
to emulate in terms of cleanliness in the demographic & health)
home & surrounding.
8. Participate in the research/studies to be Disease Notification – an integral part of disease
conducted in their respective area of surveillance.
assignment.
Disease Registry – is a compilation of information
9. Help in interpretation & implementation of PD
about a particular disease.
856 commonly known as Sanitation Code of
the Philippines. Surveillance System – were developed for
10. Assist in the Disaster Management, which monitoring high burden diseases, detecting disease
will be implemented at all levels. outbreaks that could escalate into epidemic
proportions, & monitoring progress toward
attainment of targets for the control, elimination, or
Health Statistics and Epidemiology eradication of a specific diseases.

• Health Statistics – (WHO) include both a) Active Surveillance – is a system in which

empirical data and estimates related to public health staff members actively &
health, such as mortality, morbidity, risk regularly contact health care providers or the
factors, health service coverage, and health population to obtain information about the
systems. disease of interest.
• Epidemiology – originated from the Greek b) Passive Surveillance – is a system by
words epi, meaning “upon”, demos, meaning which public health staff receives reports
“people”, and logos, meaning “study”. It is the from hospitals, clinics, public health units, or
study of the distribution & determinants of other sources.
health-related states or events in specified c) Population Size – influences the number &
populations, & the application of this study to size of health care institutions. Knowing
the prevention & control of health problems. community size provides important
information for planning.
Terms d) Composition
e) Distribution
• Study – includes surveillance, observation,
hypothesis testing, analytic research & Population Size
experiments.
• Distribution – refers to analysis by time, • The number of individuals in a population.
places, & classes of people affected. • The current population in the Philippines is
• Determinants – include all the biological, about 110 million people. The annual
chemical, physical, social, cultural, population growth rate has decreased
economic, genetic, & behavioral factors that significantly since 1960 where it was 3.3% to
influence health. now where it is about 1.3%
• Health-related States or Events – refer to • The fertility rate in the Philippines has also
disease, causes of death, behaviors such as decreased significantly over the years. In
the use of tobacco, positive health states, 1969, the fertility rate was 6.4 children per
reactions to preventive regimens & provision woman. Today, the fertility rate is 2.1 children
& use of health services. per woman. Part of the reason for this is the
• Specified Populations – include those with increased use of contraceptives and modern
identifiable characteristics such as family planning methods.
occupational groups. • With about 2 million people added to the
• Application to Prevention & Control – the population every year, the population is
aim of public health – to promote, protect & expected to double it in about 40 years.
restore good health.

2. Health Indicators – are quantitative measures,

Tools usually expressed as rates, ratios, or
1. Demography – the study of statistics such as proportions, that describe & summarize various
births, deaths, income, or the incidence of aspects of the health status of the population.

2
 to be capable of giving birth, that is, the women
• Rate – shows the relationship between a vital in the reproductive age groups.
event & those persons exposed to the No. of registered live births in a year
occurrence of said event, within a given area GFR =
Midyear population of women 15 − 44y. o
× 1000
& during a specified unit of time. It is evident
that the person experiencing the event (the
numerator) must come from the total g. Maternal Mortality Rate (MMR) – defined as
population exposed to the risk of same event “death of a female from any cause related to or
(the denominator). aggravated by pregnancy or its managing during
• Ratio – used to describe the relationship pregnancy & childbirth or within 42 days of
between two (2) numerical quantities or termination of pregnancy, irrespective of the
measures of events without taking particular duration & the site of the pregnancy.” Number of
considerations to the time or place. deaths due to pregnancy, delivery, puerperium in
• Crude or General Rates – these rates a calendar year.
referred to the total living population. It must
No. of maternal death in a year
be presumed that the total population was MMR = × 1000
No. of live births in the same year
exposed to the risk of the occurrence of the
event. h. Specific Rates of Mortality:
• Specific Rate – the relationship for a specific
population class or group. It limits the i. Specific Death Rate (SDR) – describes
occurrence of the event to the portion of the more accurately the risk of exposure of
population. certain classes or groups to particular
diseases.
No. of deaths from a specified class
SDR = × 100000
a. Crude Birth Rate (CBR) – a measure of one Midyear population in same specified class
characteristic of the natural growth or increase of
a population.
ii. Age Specific Death Rate (ASDR)
No. of registered live birth in a year
CBR = × 1000
Midyear population No. of death in a specified age group
ASDR = × 100000
Midyear population of specified age group

b. Crude Death Rate (CDR) – a measure of one

mortality from all causes which may result in a iii. Sex Specific Death Rate (SSDR)
decrease of population. No. of death in a specified sex group
SSDR = × 100000
Total No. of registered deaths in a year Midyear population of specific sex group
CDR = × 1000
Estimated population as of July 1 (same year)

i. Incidence Rate (IR) – measures the number of

c. Infant Mortality Rate (IMR) – measures the risk new cases, episodes, or events occurring over a
of dying during the 1st year of life. It is a good specified period of time, commonly a year, within
index of the general health condition of a a specified population at risk. The best measure
community since it reflects the changes in the to use for evaluating the effectiveness of heath
environment & medical condition of a community. interventions.
Deaths under 1y. o of age registered in a year No. of new cases of disease in a specified period
IMR = × 1000 IR = × 100000
Number of live births in the same year Population at risk

d. Neonatal Mortality Rate (NMR) – measures j. Prevalence Rate (PR) – measures the total
pregnancy wastage. Death of the product of number of existing cases of a disease at a
conception occurs prior to its complete particular point in time divided by the number of
expulsion, irrespective of duration of pregnancy. people at that point of time.
No. of deaths under 28 days of age in a year No. of existing cases of disease in a specified time
NMR = × 1000 PR = × 100
No. of live births in the same year No. of people examined in a specified time

e. Post-neonatal Mortality Rate (PMR) – k. Attack Rate (AR) – a more accurate measure of
measures the risk of dying the 1st month of life. It the risk of exposure
serves as an index of the effects of prenatal care No. of people acquiring a disease in a year
& obstetrical management of the newborn. AR =
No. of expose to same disease in same year
× 100

1 year of age in a year

PMR = × 1000
No. of live births in the same year
• Leading causes of morbidity
• Life expectancy
f. General Fertility Rate (GFR) – this is more
specific rate than the CBR since births are
related to the segment of the population deemed